Blepharitis: Causes, Symptoms and Treatment - Medical News Today Blepharitis: Causes, Symptoms and Treatment 4 18 Blepharitis is an eye condition affecting the eyelids and can cause clumping and stickiness around the eyelashes. This condition may be diagnosed by an optometrist after a person with blepharitis has these signs pointed out to them by a family member, friend or colleague. Contents of this article: Treatment and prevention of blepharitis What is blepharitis? Blepharitis is a common eye condition that is not specific to any one group of people.1 As such, it can affect:1 Blepharitis is a condition of the eyelids around the base of the eyelashes. Children and adults People of all ethnicities People of any gender. A high proportion of patients seeking help with ocular conditions from health care professionals specializing in eye care are diagnosed with blepharitis.

In a 2009 survey, carried out in the US, 37% of patients seen by an ophthalmologist, and almost half (47%) of patients seen by an optometrist had signs of blepharitis.1,2 The total number of cases at any one time in the US is not known, but estimates may be drawn from data from 1982, when there were nearly 600,000 patient consultations about blepharitis.1 Blepharitis is classified as either acute or chronic, with chronic adult blepharitis the most common form of the eye condition.1 Blepharitis is further defined by the exact location of the problem, whether at the front or the back of the eyelid.1 For most purposes, blepharitis is taken to mean the chronic form of eyelid inflammation, which will be the focus of this information page. The following YouTube video, from the American Academy of Ophthalmology, gives a very short and straightforward visual description of blepharitis. Fast facts on blepharitis Here are some key points about blepharitis. More detail and supporting information is in the body of this article.

Blepharitis is an inflammatory condition affecting the area around the base of the eyelashes. The acute form of blepharitis is sometimes described as an eyelid infection (bacterial or viral), whereas chronic forms of the inflammatory condition are diagnosed as blepharitis. If the condition affects the top, outer side of the front of the eyelids, it is called anterior blepharitis: a condition with a disease process similar to that of seborrheic dermatitis of the face and scalp. If the condition affects the underside of the front of the eyelids (the moist side in contact with the eye near the eyelashes), it is called posterior blepharitis. This shows a similar disease process to the anterior version, but also specifically affects the little glands that secrete an oily substance onto the eye. While the disease process is well described, the underlying causes of chronic blepharitis are not well understood. Bacteria can be associated with the condition, with Staphylococcus infection more common in women than men. Blepharitis is not caused by poor hygiene.

The most obvious signs of blepharitis are redness and stickiness of the eyelid, with clumping of scaly skin around the base of the eyelashes. Treatment aims at relieving symptoms, but is generally not curative, even when prescription drugs or ointments are used. Treatment is typically effective at managing symptoms. Blepharitis treatment is usually lifelong and involves a ten minute cleansing process performed twice daily. The patient applies warm compresses to loosen the crusty skin and then uses a gentle scrub to clear away this dead skin. Blepharitis that affects the glands near the base of the eyelids may also be relieved by massaging the glands to express the (often thicker) contents and clear blockages. What causes blepharitis? The cause of blepharitis differs by type, whether acute or chronic, and for the latter cases, by whether it affects the outside or the underside of the eyelids.

The underlying reason for the inflammatory condition is not understood, with the "cause" relating instead to observations of the disease processes.3-5 Acute blepharitis can be ulcerative or non-ulcerative:5 Ulcerative acute blepharitis is usually caused by an infection - usually bacterial and usually staphylococcal. A viral cause is also possible, such as infection with Herpes simplex and Varicella zoster. Non-ulcerative acute blepharitis is usually an allergic reaction. Examples of this include atopic blepharo-dermatitis, seasonal allergic blepharo-conjunctivitis, and dermato-blepharo-conjunctivitis. The diagnosis of blepharitis is usually concerned with the chronic forms - the focus of this article. Although academic descriptions classify up to six specific forms of chronic blepharitis,4 for practical purposes it is enough to look at two broad types according to the part of the eyelids affected:1,3-6 In anterior blepharitis affecting the outer part of the front of the eyelids, a bacterial (usually staphylococcal) or seborrheic disease process is involved.

Seborrhea is poorly understood; it manifests as dandruff when it affects the scalp.7 Patients with anterior blepharitis often also have seborrheic dermatitis of the face and scalp, or another skin condition called acne rosacea . In posterior blepharitis affecting the underside of the front of the eyelids, there is a problem with the glands near the base of the eyelashes (the condition is also known as Meibomian gland dysfunction, MGD). The glands over-secrete their oily substance or become blocked. The reason for this is not well understood, although hormonal causes are suspected and the condition is often associated with acne rosacea. Posterior blepharitis can also be associated with seborrheic dermatitis. Signs and symptoms of blepharitis The main features of blepharitis are the following problems with the eyelids:1 Itchiness Flaking Crusting.

The crusting may be more prominent on waking in the morning - all of the symptoms generally tend to be worse at this time.1,3,4,6 Complaints also include:1,3,4 Sensations of burning, itching, irritation or that there is a foreign body or a grittiness in the eyes Excessive eye watering, tears ( epiphora ) Conversely, dry eyes (especially with posterior blepharitis) Stickiness of the eyes Oversensitivity to light (photophobia) Intolerance to wearing contact lenses. Blepharitis is not a sight-threatening problem, but it can result in decreased vision, which can come and go.1,4 The condition usually affects both eyes3,4 - it is bilateral - and if it is present in only one eye, this can lead a physician to suspect an alternative diagnosis.4 The symptoms of chronic blepharitis tend to come and go, with periods of remission (a pause in symptoms) followed by exacerbations (a flare up).3 The next section will discuss signs of blepharitis - that is, the problems visible to a doctor that help them to diagnose the condition.

Diagnosis and tests for blepharitis Broadly, there are three types of blepharitis: acute blepharitis (which may be diagnosed as lid infection instead); and two chronic forms (which are also known as lid inflammation ).3 Chronic blepharitis is usually either anterior blepharitis or posterior blepharitis (also known as Meibomian gland dysfunction, or MGD):3,6 Anterior blepharitis affects the outer side of the front of the eyelids Posterior blepharitis affects the underside of the front of the eyelids (the moist side in contact with the eye). In a case that shows both anterior and posterior blepharitis, the diagnosis is termed marginal blepharitis.3 Doctors will first determine a diagnosis of blepharitis by asking about symptoms (taking a history). After confirmation of symptoms listed above , the doctor will then examine the patient's eyelids and eyes.

Slit-lamp examination to find signs of blepharitis When carrying out an eye examination, the doctor will look for signs that help them determine the specific type of blepharitis, and the appearance of various features that can help to further sub-diagnose the problem.3 A suspected case of blepharitis is best examined under a slit-lamp. Initial consultations may involve examinations without any special equipment until a more specialized examination is possible using a slit lamp. A slit lamp is a specially developed, low-power microscope with an intense thin-beam light source. This lamp allows the doctor to look at the outside of the eyes and the eyelids while the patient's head is held steady by resting the chin and forehead against supports.8 Anyone who has recently had a vision test at their optometrist's office will likely be familiar with this piece of equipment.

Use of a slit lamp usually reveals the following signs of anterior blepharitis:3 Redness (erythema) and swelling ( edema ) of the eyelid margin, and telangiectasia (appearance of small blood vessels because they are widened) on the outside of the eyelid Brittle scales in the eyelashes, forming "collarettes" around the lashes, from the base up as they grow Eyelashes pointing toward the eye (trichiasis) in severe and chronic cases Depigmentation (loss of color) of the eyelashes (poliosis) Loss of eyelashes (madarosis) Ulceration and scarring of the eyelid, and scarring of the cornea. Posterior blepharitis tends to show the following signs:3 Meibomian glands may be capped with oil, dilated, or obstructed The glands' secretions may be thicker Telangiectasia(s) and lid scarring may also be present in the area around the glands. Examination of the moisture over the eyes can reveal a sign common to all diagnoses of chronic blepharitis - instability in the tear film.

This instability in the moisture of the eyes may be a result of rapid evaporation caused by abnormal lipid composition in the secretions from the Meibomian glands.5 Treatment and prevention of blepharitis Self-care and home treatment of blepharitis Eyelid hygiene is the mainstay of treatment for both types of blepharitis and is something that should be maintained even when symptoms are in remission.3 Self-care is the most important element of treatment, augmented by help from a doctor or eye care specialist. Blepharitis cannot be cured, but treatment is successful at managing symptoms.3,4 Symptoms of blepharitis will recur if self-care is not maintained, even after symptoms clear up; believing that the problem has been cured is a false hope.

In addition to home treatment, people with the eyelid inflammation should avoid using cosmetics such as eyeliner, mascara and other make-up around the eyes.4,11 Management of both anterior and posterior forms of blepharitis involves a two-part process of lid hygiene, with a third element added for posterior blepharitis management:3,4,6,9,10 Warm compresses - to loosen crusts Lid cleansing - to remove crusts Massage - to express the small oil glands of the eyelids. A warm compress helps to soften and loosen oily plugs and crusts, by diluting sebum and dilating the ducts of the glands secreting this oil.4,5 Using a warm compress simply means placing a warm cloth over closed eyelids, reheating the compress with warm water when it cools and reapplying for up to 10 minutes.4,5 To ensure safety when using warm compresses and blepharitis treatments, be sure to follow physician advice and to heed the warnings of doctors who have shared patients' experiences in a medical journal:11 Dip the cloth in warm water - some patients have suffered facial burns by using a microwave to heat up the wet cloth.

Use a soft cloth only - one patient resorted to using a toothbrush and scrubbing vigorously, causing damage to his skin and eye. After a warm compress has been applied for up to ten minutes, the patient should then cleanse their eyelids. This is done by gently rubbing the margin of the eyelid (at the base of the eyelashes, and where the glands are located) with a cotton swab soaked in a dilute solution of baby shampoo (2-3 drops in about half a cup of warm water).4,5 This lid hygiene needs to be maintained as a self-care regime twice a day every day. Although this is a considerable lifelong commitment, without this hygiene regimen the troublesome symptoms of blepharitis will recur.3,4,6 This hygiene is necessary for both types of blepharitis, and the third element - massage - is necessary for posterior blepharitis (Meibomian gland dysfunction). Massage helps to express the oily contents of the glands after first loosening the sebum with the warm compress.

To do this effectively, use a finger or a cotton-tipped applicator/swab to massage the margin of the eyelid (where the eyelashes and glands are) using small circular motions.3,4,6,9,10 Some patients prefer using warming eye masks to achieve the same effects as the warm cloth compresses. These masks may be more convenient, especially given the need for a twice-daily lifelong regime. Eye scrubs are also available and offer an alternative to the use of dilute baby shampoo.4 Replacement tear drops or "artificial tears" available without a prescription will help to counter the dryness of the eyes caused by blepharitis during the day.

Similarly, bland ointments available from the pharmacy may help to retain moistness in the eyes overnight.5 Antibiotics and other prescribed medicines for blepharitis The American Academy of Ophthalmology (AAO) published their Preferred Practice Pattern guidelines in October 2013, including advice on the assessment, diagnosis and management of blepharitis.13 In brief, the AAO guidelines recommend that physicians:13 Attempt to treat moderate to severe blepharitis with eyelid hygiene and topical antibiotics prior to intraocular surgery Avoid the use of costly new technologies (including devices using thermal pulsation) as these are not currently supported by sufficient evidence May prescribe topical antibiotic ointments with or without corticosteroids or oral antibiotics (azithromycin should be used with caution in patients with cardiovascular problems as it may adversely affect heart rhythm) Consider the possibility of carcinoma as a differential diagnosis in patients with chronic blepharitis that does not respond to therapy, particularly if the patient is experiencing a loss of eyelashes).

There is a need for further clinical trials to establish the safety and benefits of drug treatments for blepharitis in addition to current self-care recommendations.12 Recent trials have, however, shown that antibiotics and topical corticosteroids can produce significant improvements.12 Doctors will typically recommend these only when hygiene alone has not worked, although antibiotic ointments are always indicated in acute cases of blepharitis that have a bacterial cause; oral antiviral drugs are prescribed for acute viral cases.5 Combination drug ointments are prescribed by doctors to address both the infectious and inflammatory elements of blepharitis.12 Blepharitis. Treatment and Causes. Eye lid inflammation | Patient 448 Blepharitis means inflammation of the eyelids. It causes the eyes to feel sore and gritty. It can be a troublesome and recurring condition with no one-off cure. However, once symptoms have improved, daily eyelid hygiene can usually keep symptoms to a minimum. Eyesight is rarely affected. What is blepharitis? Blepharitis is an inflammation of the eyelids. It usually affects the edges (margins) of the eyelids. It is not usually serious, but may become an uncomfortable, irritating problem.

Blepharitis is typically persistent (chronic). Both eyes are usually affected. What causes blepharitis? There are three main types of blepharitis: staphylococcal blepharitis, seborrhoeic blepharitis and meibomian blepharitis. All three types can cause similar symptoms. Staphylococcal blepharitis This type of blepharitis is thought to be caused by a germ (bacterium) called staphylococcus. This bacterium commonly lives in low numbers on the skin without doing any harm. However, in some people, it seems that this bacterium causes an infection of the eyelids, resulting in blepharitis. Exactly why or how this happens in some people is unclear. Seborrhoeic blepharitis Seborrhoeic blepharitis is closely associated with a skin condition called seborrhoeic dermatitis. In seborrhoeic dermatitis, the affected skin becomes more oily and can become scaly. Seborrhoeic dermatitis typically causes bad dandruff and sometimes a rash, commonly on the face and upper body.

The underlying cause of seborrhoeic dermatitis is not clear. A type of yeast called Malassezia furfur is involved. However, it is not just a simple skin infection and it is not contagious, ie you cannot catch this condition from others. This yeast lives in the oil (sebum) of human skin in most adults and usually does no harm. However, in some people the yeast seems to trigger an inflammatory reaction, causing the blepharitis. Meibomian blepharitis This is also known as meibomian gland dysfunction. The tiny meibomian glands in the eyelids lie just behind the eyelashes. You have about 25-30 meibomian glands on each upper and lower eyelid. They make a small amount of oily fluid which comes out on the inside of the eyelids next to the eye. This oily fluid forms the outer layer of the tear film which lubricates the front of the eye. People with meibomian blepharitis are thought to have a slight problem with their meibomian glands and the fluid they produce. This may lead to eyelid inflammation.

This also explains why people with meibomian blepharitis often have dry eyes as the fluid they make may not be adequate to lubricate the eye. Combinations of the above In practice, it is often not possible to tell the difference between the above causes. Indeed, seborrhoeic blepharitis commonly occurs together with meibomian blepharitis. Furthermore, skin which is inflamed in any way is more likely to become infected by staphylococcus. So, all three causes may contribute to each case of blepharitis, with the main cause varying. What are the symptoms of blepharitis? The main symptom is sore eyelids. Both eyes are usually affected. The eyes may feel gritty, itchy or as though they are burning. The eyelids may look inflamed or greasy. The eyes may become sticky with discharge. In particular, the eyelids may stick together in the morning. Sometimes tiny flakes or scales appear on the eyelids, which look like small flakes of dandruff. Crusts may develop at the base of eyelashes. One or more of the tiny glands of the eyelids (meibomian glands) may block and fill with an oily fluid.

From Wikimedia Commons Symptoms often come and go. Typically, symptoms flare up from time to time, but you may have long periods without any symptoms. Three other conditions are commonly associated with blepharitis. They are: Dry eye syndrome (keratoconjunctivitis sicca). Seborrhoeic dermatitis - described above. See separate leaflets called Seborrhoeic Dermatitis , Dry Eyes and Rosacea for further information. What are the possible complications of blepharitis? In most cases, blepharitis is uncomfortable but not serious or sight-threatening. Complications are uncommon. They include: Chalazion (meibomian cyst). This is a painless swelling, most prominent on the inside of the eyelid. It is due to a blocked meibomian gland. Although it is painless, it may make the eyelid bulge and look a little unsightly. It can easily be treated. Sometimes a chalazion can become infected and painful. See separate leaflet called Chalazion for further information. Stye. This is a painful infected swelling most prominent on the outside of the eyelid.

It is due to an infection of the root (follicle) of an eyelash. See separate leaflet called Stye for more information. Contact lens wearers may find their lenses feel uncomfortable when they have a flare-up of blepharitis. Changes to the eyelashes (which mainly occur in severe and long-standing cases). These include: Loss of eyelashes (madarosis). Misdirection of eyelashes towards the eye (trichiasis). Loss of the colour of the eyelashes (poliosis). Eyelid ulceration and scarring (uncommon). This can cause the eyelid to turn inwards against the eyeball ( entropion ) or outwards ( ectropion ). Inflammation of the front of the eye (conjunctivitis). This may cause a sore, red eye with discharge or watering. See separate leaflet called Infective Conjunctivitis for more information. Conjunctival phlyctenules. These are small (1-3 mm), hard, triangular, yellowish-white lumps (nodules) surrounded by prominent but tiny blood vessels. If they develop they usually occur on the lower part of the eye just below the transparent front part of the eye (the cornea).

They consist of white blood cells that collect in response to bacterial infection - such as staphylococcus. Inflammation of the cornea (keratitis), ulceration, and scarring. This complication is rare but serious as it can affect sight. See a doctor urgently if you develop eye pain (more than the irritation/grittiness of dry eye) or any loss of vision from the affected eye. What is the treatment for blepharitis? There is no one-off cure for blepharitis, as the inflammation tends to recur if you do not keep up with treatment. However, with regular treatment, symptoms can usually be eased and then kept to a minimum. This helps to prevent flare-ups. The aim of treatment is to control or manage blepharitis, not to cure it. Most of the treatment is done by you, rather than having prescriptions or treatments from your doctor. The main treatment is regular eyelid hygiene (see below). Other treatments that may be needed include antibiotics, artificial tear drops and specific treatment for associated conditions. Regular eyelid hygiene This is the most important part of treatment and prevention of blepharitis.

The aim is to soothe the eyelids, unplug any blocked meibomian glands and clear out any stagnant oily secretions from these glands. The eyelids are cleaned and debris is removed. This is a daily routine that consists of three parts - warmth, massage and cleansing. Remove any contact lenses before following the routine. Warmth The purpose of warmth is to soften the skin and any crusts attached to the eyelids. It also allows the oily secretions made by the meibomian glands to flow more freely, as warmth makes oils more runny. Therefore, warmth helps to unplug any blocked glands and allow the oily secretions to flow more readily. Warmth applied to the eyelids for five to ten minutes is sufficient to do this. The traditional method is to press on the eyelids gently with a flannel (facecloth) soaked in very warm water for 5-10 minutes. If the flannel cools, keep re-warming it in the warm water. A popular alternative is to use a specially designed reusable heat bag which you place over your eyes for about five minutes. There are a number of such eye bags available, which you can buy from some opticians or online.

The heat bags are warmed in a microwave. The advantage of a heat bag over a hot flannel is that the heat is retained for many minutes and so it keeps a constant warmth over the eyes. You can simply lie down and relax for five to ten minutes with the bag placed over your eyes. (A hot flannel usually cools quickly.) Massage Massage the eyelids immediately after applying the warmth. Massaging helps to push out the oily fluid from the tiny meibomian glands. To massage the eyelids: Massage along the length of the upper and lower eyelids towards the eye. That is, sweeping downwards when moving along the upper eyelid, and upwards when moving along the lower eyelid. The idea is that you are moving the oily secretions toward the edge of the eyelid so that they can come out of the glands. Repeat this massage action 5 to 10 times over about 30 seconds immediately following the warming. Massaging should neither to be too gentle nor too firm. It should be relatively comfortable and you should not press hard enough to actually hurt your eyeball under the closed lids. Always massage with the eyes shut. More related content Clean After warmth and massage, clean the eyelids.

This can be done by any of the following ways. There is a lack of research studies to say which is the best method, so use whatever you find most useful: The traditional way is to use a cotton wool bud that has been dipped in diluted baby shampoo. Just add a few drops of baby shampoo to a small cup of warm water so that the ratio of water to shampoo is about 10:1. Squeeze out excess liquid from the cotton bud to prevent drips getting into your eyes, which may irritate. In particular, try to clean off any crusts at the base of the eyelids. After cleaning the eyelids with the cotton wool bud, wash off the shampoo from the eyelids, using a flannel or cloth. Some people recommend using sodium bicarbonate (a teaspoonful in a cup of cooled water that has recently been boiled). This is applied using a clean cloth or cotton wool bud. This may cause irritation to the eyes in some people. Some people recommend using special eyelid scrubs that you can buy at some opticians/optometrists.

Some people say that simply washing the eyelids with cooled water that has recently been boiled (or preserved water for contact lens wearers) is probably as effective as using water with added sodium bicarbonate or baby shampoo. You should do the above routine - warmth, massage, clean - at least twice a day until symptoms settle. When the symptoms have eased, keep doing this routine once a day, every day, to prevent further flare-ups. If you are prone to blepharitis it is best to think of this as part of your daily routine - just like brushing your teeth. This is the best way to keep symptoms away, or to a minimum. Artificial tear drops Blepharitis is often associated with dry eyes. This is because the tear film is produced by the meibomian glands. So if they are blocked or not working well, your eyes will not be as well lubricated. Therefore, artificial tear drops may help ease symptoms. These come as eye drops and gels. You can buy them at pharmacies or get them on prescription. You may need to use them regularly to keep symptoms away. There are several types of artificial tear drops and gels with different ingredients. Occasionally, some people find one type may irritate.

A change to a different preparation may help if the first does not suit. Antibiotic treatments Antibiotic eye ointment or drops may be advised for a while if an eyelid becomes infected. If you are prescribed ointment, place it on the edge of the eyelid (not the eye) after cleaning the eyelid in the way described above. You will normally need to use these drops for six weeks. Antibiotic tablets are also sometimes used for troublesome infected eyelids. Note: a three-month course of antibiotics is typically used in the treatment of blepharitis. Further advice Wearing eye make-up, particularly eyeliner, may make symptoms worse. It is best to avoid eyeliner, particularly during a flare-up. Rubbing your eyelids may make inflammation worse, so try to avoid doing this. Studies suggest that omega 3, found in fish oils, may improve symptoms for people with dry eye syndrome and blepharitis. It is not yet known how much should be used, but it may help to take omega-3 supplements, available in health food shops and pharmacies. Alternatively, you could eat one to four portions of oily fish each week.

However, if you are pregnant, or trying to become pregnant, you should not eat more than two portions of oily fish per week. This is because it may contain substances such as mercury which can damage the development of a baby in the womb. As mentioned above, blepharitis commonly develops in people with seborrhoeic dermatitis, rosacea or dry eye syndrome. If relevant, treatment of these other conditions may also help to ease symptoms of blepharitis. Blepharitis - COMPLETE information about Blepharitis - Hpathy Unclean personal habits, using dirty linen frequently to clean the eyes thus transmitting infection. Extension from surrounding areas like chronic conjunctivitis and recurrent dermatitis or chronic dacryocystitis. Refractive errors and muscle imbalance have been considered an important cause. Systemic cause like septic foci in the body. Allergic cause either exogenous or endogenous. Deficiency of vitamin-B complex as a part of the syndrome of angular stomatitis and angular conjunctivitis. Rarely specific diseases like syphilis, tuberculosis, leprosy, parasitic and mycotic infections may cause blepharitis.

blepharitis symptoms People who have blepharitis may experience any of the following symptoms: eye irritation, redness, tearing, feeling of something in the eye, itching, burning, occasional sharp pains, ache in or around the eye, sensitivity to light, blurring. “film” over the eye, crusting or mattering at the base of the eyelashes, and frequent stye or chalazion formation. The symptoms may be most noticeable upon awakening, because the eyes have been bathing in the irritating secretions of the oil glands all night. During the day, these secretions are partially washed away by the blinking of the eyelids and the flow of tears, some of the symptoms of blepharitis may also be caused by other eye problems, such as dry eye syndrome or allergic problems. Many people actually have both dry eye syndrome and blepharitis at the same time. Diagnosis of blepharitis Diagnosis depends on patient on patient history and characteristic symptoms. In staphylococcal blepharitis, culture of ulcerated lid margin shows S. aureus. Homeopathic treatment for blepharitis Homeopathy is one of the most popular holistic systems of medicine.

The selection of remedy is based upon the theory of individualization and symptoms similarity by using holistic approach. This is the only way through which a state of complete health can be regained by removing all the sign and symptoms from which the patient is suffering. The aim of homeopathy is not only to treat blepharitis but to address its underlying cause and individual susceptibility. As far as therapeutic medication is concerned, several remedies are available to treat blepharitis that can be selected on the basis of cause, sensations and modalities of the complaints. For individualized remedy selection and treatment, the patient should consult a qualified homeopathic doctor in person.

There are following remedies which are helpful in the treatment of blepharitis: Antim crud, Apis Mel, Argentum Met, Argentum Nit, Calcaria Sulph, Carbn Sulph, Euphrasia, Graphites, lycopodium, Medorrhinum, Mercurius, Petroleum, Rhus Tox, Staphisagria, Sulphur, Tellurium, Sanicula, Aconite, Arsenic Album, Carbo Animalis, Hepar Sulph, Iris, Kali Carb, Natrum Carb, Natrum Mur, Nitric Acid, Psorinum, Pulsatilla, Sepia, Silicea, Thuja, and many other medicines. About the author Hpathy This article and all other content at Hpathy.com is copyright protected by Hpathy.com. Any unauthorized copying to other websites or journals is not permitted. See the full Copyright Notice and Disclaimer at Hpathy.com Blepharitis: Causes, Treatment of Eyelid Inflammation By Brian Chou, OD Like This Page? Please Share!

Blepharitis is a common eyelid inflammation that sometimes is associated with a bacterial eye infection, symptoms of dry eyes or certain types of skin conditions such as acne rosacea . Blepharitis has two basic forms: Anterior blepharitis, affecting the outside front of the eyelid where eyelashes are attached. Posterior blepharitis, linked to dysfunction of meibomian glands within the eyelids that secrete oils to help lubricate the eye. It's common to have a mixture of both anterior and posterior forms of blepharitis at the same time, but in different degrees of severity. Although eye doctors commonly diagnose blepharitis, it can be difficult to find permanent relief of the symptoms that can include burning, flaking, crusting, tearing, irritation, itching, redness in eyelid margins and a foreign body sensation . Blepharitis can cause inflamed eyelids, eye burning and dryness. Treatment For Blepharitis If you are diagnosed with chronic blepharitis, your eye doctor will likely recommend an ongoing regimen of eyelid hygiene ( see below ) that can include commercially developed, over-the-counter lid scrubs or other recommended cleansing agents.

Eyelid hygiene is the cornerstone of treatment for most cases of blepharitis. Besides a program of eyelid hygiene, the severity of the blepharitis and related symptoms may require supplemental treatment with topical and oral medicine. In some cases of posterior blepharitis, eye doctors recommend nutritional supplementation with omega-3 fatty acids , such as flaxseed oil , to aid healthy function of meibomian glands that provide essential lubrication for eye and eyelid comfort. Recommended For You Anterior Blepharitis Symptoms of bacteria-caused staphylococcal blepharitis often are more severe and can even lead to loss of eyelashes. Besides eyelid cleansing and hygiene, an antibiotic ointment for eyelids might be prescribed. Pink eye due to bacteria  a common type of eye infection  may occur simultaneously with blepharitis. Viruses and other types of bacteria besides staphylococcus also can cause anterior blepharitis. Without treatment, blepharitis caused by bacteria can cause long-term effects such as ectropion , thickened lid margins, dilated and visible capillaries, trichiasis and entropion .

In cases of trichiasis and entropion, the cornea may exhibit significant erosion from eyelashes rubbing against the eye. Seborrheic blepharitis is caused by seborrheic dermatitis, a skin condition that creates flaking and scaling  including on the eyelids. Regular cleansing with eyelid scrubs and gentle, non-detergent shampoos can provide significant relief and improve the appearance of eyelids. The American Academy of Dermatology notes that the causes of these skin conditions are not well understood. But seborrheic dermatitis sometimes appears in a person with a weakened immune system. Fungi or certain types of yeast that feed on oils ( lipids ) in the skin also may lead to seborrheic dermatitis, with accompanying blepharitis. What is more important than your vision? Find local eye doctor to get an eye exam With demodex blepharitis, microscopic mites (demodex folliculorum) and their waste materials could cause clogging of follicles at roots of eyelashes, and in some cases might be associated with development of skin conditions such as rosacea and blepharitis.

A commercial eyelid scrub combined with tea tree oil may be effective for treating this type of blepharitis.* Other reported treatments of demodex blepharitis include sulfur oil and steroids. An anti-parasitic gel (metronidazole) also has shown effectiveness as a treatment. Another version of these mites (demodex brevis) can be found more generally in oil glands of the skin and eyelids, which also may contribute to blepharitis symptoms. While presence of these tiny mites is common in everyone, researchers speculate that some people develop demodex blepharitis due to unusual allergic or immune system reactions leading to inflammation. Posterior Blepharitis Posterior blepharitis involves dysfunction of oil-secreting meibomian glands within the eyelids. The openings of these glands are at the inner edge of the eyelids, and oils secreted by the meibomian glands help prevent tear evaporation. Also called meibomian blepharitis, meibomitis or meibomian gland dysfunction (MGD) , posterior blepharitis reduces meibomian gland output or produces abnormal oily secretions.

Symptoms of posterior blepharitis include inflamed and thickened eyelid margins, eyelid crusting and other symptoms that are often difficult to manage. With this type of blepharitis, tears can even look foamy. Meibomian blepharitis sometimes is described as dry eye syndrome caused by meibomian gland dysfunction. Rosacea blepharitis often is a component of ocular rosacea , which can cause eyelid inflammation linked to dysfunction of the skin's oil (sebaceous) glands. Acne rosacea is a common skin inflammation characterized by pimple-like bumps and facial redness  especially around the cheeks, nose, forehead and chin. As with certain forms of blepharitis, underlying causes of rosacea aren't well understood. However, rosacea does appear to be linked to certain genetic tendencies and environmental factors, such as excessive sun exposure. Clogged meibomian glands from posterior blepharitis also can cause a stye or chalazion to form. A stye, which is often uncomfortable, grows from an infected oil gland in the eyelid.

A chalazion is a non-infected, usually painless nodule caused by inflammation of a blocked meibomian gland. SEE ALSO: How to Get Rid of a Stye > Good Eyelid Hygiene Relieves Blepharitis Symptoms Blepharitis can be difficult to manage because it is often chronic, meaning that it never goes away completely. Your eye doctor may recommend one or more of these steps involving good eyelid hygiene and massage: Top: Use a cotton-tipped swab to apply cleaning solution recommended by your eye doctor. Rub gently around the edges of your upper and lower eyelids, but do not get cleaning solution in your eye. Bottom: The goal of blepharitis treatment is to return your eyelids to a normal, healthy state. Apply a warm compress such as a washcloth to the outer eyelids. Cleanse the eyelids with a commercial lid scrub or other recommended product. Gently massage the outer eyelids. A warm compress loosens the crust on your eyelids and eyelashes before you clean them. The warmth also can loosen any blocked residue in the oil-secreting meibomian glands in your eyelids.

To use a warm compress: Wash your hands, then dampen a clean washcloth with warm water. Place the washcloth over your closed eyes for several minutes. Open your eyes, and then use fingers to rub gently around the outer eyelids in a circular motion. Don't press too hard on the eyeball. Follow your doctor's recommendations on how often to use a compress and how long it should be kept in place. When you first begin treatment, your eye doctor may suggest that you do this several times daily, for about five minutes each time. Later on, you might apply the compress once daily for a few minutes. Cleaning the eyelids is essential to blepharitis treatment. Your doctor will recommend what cleansing agent to use, such as warm water only, baby shampoo diluted with warm water or a special over-the-counter product made specifically for cleansing the lids. To clean eyelids: Wash your hands, then dip a clean washcloth, cotton swab or gauze pad into your cleaning solution. Make sure you squeeze out any excess moisture. Gently wipe across your lashes and lid margin. Rinse with cool water. Repeat the process for your other eye, but use a different washcloth, swab or pad.

Your eye doctor may have you clean your lids several times daily to start, and then once daily thereafter. Is There A Cure For Blepharitis? A complete blepharitis cure may not exist. But as explained above, good eyelid hygiene and prescription medicine are often effective in managing blepharitis, while warm compresses and lid massages can help unclog obstructed meibomian glands. If you wear soft contact lenses , your eye doctor may prescribe RGP contacts instead or may recommend more frequent replacement of your soft contacts to reduce lens deposits that may be associated with your blepharitis. Depending on the severity of your symptoms, you may need to discontinue contact lens wear altogether for a while. It's a good idea to minimize use of eye makeup, which can interfere with eyelid hygiene. If your doctor recommends an anti-dandruff shampoo for your scalp and eyebrows, make sure you keep the shampoo out of your eyes to avoid irritation. Also, as mentioned above, certain eye doctors recommend nutritional supplementation with omega-3 fatty acids to improve function of the eyelid's oil glands.

Because blepharitis and dry eyes commonly occur together, your eye doctor may advise you to use over-the-counter or prescription eye drops to help relieve symptoms. In severe cases of dry eye, especially without significant blepharitis, you may benefit from the insertion of punctal plugs in tear drainage channels in your eyelids to help increase the amount of lubricating tears on the surface of your eye. More moisture on the eye's surface can make your eyes feel better and healthier. Home » Conditions » Blepharitis | En Español References & Notes >> The role of omega-3 dietary supplementation in blepharitis and meibomian gland dysfunction (an AOS thesis). Transactions of the American Ophthalmological Society. December 2008. Blepharitis. Ophthalmology, 3rd ed. 2008. *Corneal manifestations of ocular demodex infestation. American Journal of Ophthalmology. May 2007. Marilyn Haddrill , Gina White and Gary Heiting, OD also contributed to this article. [Page updated December 23, 2016] Like This Page? Please Share!

Recommended For You Eyelid Inflammation (Blepharitis) Causes, Symptoms, Treatment - Exams and Tests - eMedicineHealth Exams and Tests Eyelid Inflammation (Blepharitis) Topic Guide Exams and Tests Your ophthalmologist or primary-care physician usually diagnoses this condition after a careful history and an examination of your eyes and eyelids. The exam usually consists of checking the vision after which the lids are examined, usually using the slit-lamp (microscope) if an ophthalmologist is consulted (the primary-care physician doesn't use a microscope). Other diseases may affect your eyelids, so some of the questions or the examination may be focused on other parts of your body, as well as any medications, such as chemotherapeutic agents or antidepressants , that you are taking. The work environment, including exposure to any chemicals, may also be explored. Occasionally cultures are taken -- swabbing the discharge and sending this to the laboratory to look for specific organisms. This is usually reserved for infections that don't respond to the usual medications. If it is suspected that the blepharitis is related to or caused by a systemic disease, a more complete evaluation by your primary-care physician may be indicated.

In some cases, an allergy evaluation may be required. Medically Reviewed by a Doctor on 2/26/2015 Medical Author: Blepharitis or Eyelid Inflammation: Causes and Treatment Blepharitis or Eyelid Inflammation: Causes and Treatment Authored by Michael Garin O.D. Blepharitis (blef-are-eye-tis) is a usually non-contagious and common eye disorder that affects all ages and both sexes, and may be associated with bacterial infection or skin disorders such as rosacea or seborrhea. It inflames the eyelash follicles along the edge of the eyelid, forming dandruff-like scales on the eyelashes. Oil glands (meibomian glands) run along the edges of the eyelids, and when these glands become irritated or inflamed, the oil secretions thicken and do not flow properly. The meibomian secretions are an important part of a healthy tear film, and their absence can cause the tear layer to become unstable or evaporate quickly. Although most experts treat it as a serious condition, blepharitis alone is not known to cause any permanent damage to eyesight.

If blepharitis is severe, then related problems affecting the cornea can threaten vision. Eye care professionals usually become aware of the condition in the course of comprehensive eye examinations. What Are The Symptoms of Blepharitis? There are many symptoms that may signal the presence of blepharitis or eyelid inflammation. Some of these symptoms are more severe than others, and sometimes a person will not experience any of these symptoms at all. The most common symptoms include: Crusty discharge on the lashes or lids, especially when first awakening Fluctuating vision due to secondary dryness and an unstable tear film How Many Types of Blepharitis Are There? Blepharitis can be divided into two sub-types based on whether it predominantly affects the anterior (front) eyelid structures or the posterior (back) eyelid structures. Some people have predominantly anterior or posterior blepharitis, and some people have both. Anterior Blepharitis: This type affects the outside front edge of the eyelid, where the eyelashes grow, and is usually caused by bacteria (staphylococcal blepharitis) or dandruff of the scalp and eyebrows (seborrheic blepharitis).

In rare cases, it is caused by allergies or an infestation of the eyelashes by mites or lice. Posterior Blepharitis: This type of blepharitis affects the meibomian glands, which are located just within the eyelid margin. There are twenty to thirty meibomian gland openings on each eyelid margin. The inflammation causes thickening of the oil secretions so that the oil does not flow as well, causing secondary dry eye and chronic inflammation, redness, thickening, and notching of the eyelid margin. This condition may also be referred to as rosacea-associated blepharitis, because it is often seen in people with rosacea. What Causes Blepharitis To Develop? Blepharitis can develop for a number of reasons. In many cases it’s either by bacteria or by the skin condition called seborrhea, which is similar to dandruff. Other times it’s due to severe allergies or plugged oil glands and rosacea. Although it is not as common, blepharitis is sometimes due to an infestation of the eyelashes by mites or lice.

Risk factors may include: Age Exposure to chemical or environmental irritants like smoke or smog Hands that remain dirty for most of the day, such as during a work shift, or poor hygiene What Are My Treatment Options for Blepharitis? Depending on which type of blepharitis you have, there are a variety of ways to treat this condition. With any type of blepharitis, the cornerstone of treatment is keeping the eyes clean and free of debris with hot compresses and gentle lid hygiene. Warm compresses are a mainstay of all treatments for blepharitis. The heat and moisture can soften flakes and debris on the eyelashes, making them easier to clean. The heat also helps to encourage the flow of oil from the meibomian glands. Blepharitis is a chronic condition, and it is helpful to make warm compresses a part of your daily routine, and to apply them more often when symptoms flare. After a warm compress, gently massage the eyelid margins to prompt the flow of oil from the meibomian glands. Gently wash the eyelids and eyelashes with baby shampoo diluted with water, or a commercial eyelid cleanser such as those made by Ocusoft.

Wrap a washcloth around your index finger or use cotton swabs to clean. Avoid rubbing too hard, and rinse with warm water when finished. Additional treatments include: Short courses of topical steroid drops for flares (only under a doctor’s supervision) Oral antibiotics, especially for posterior blepharitis Using anti-dandruff shampoo/conditioner on the scalp (for patients with seborrheic dermatitis) Reducing time spent wearing eye make-up; always take make-up off before bed Discontinuing use of contact lenses until symptoms improve. When a contact lens wearer experiences redness, pain, and/or blurred vision, he or she should always remove the contact lenses and contact his or her eye care provider for advice, as this may signal a more serious issue. Avoiding environmental irritants (e.g., dust) Take omega-3 fatty acid supplements, because omega-3 helps with the proper function and regulation of the eyelid glands and has an anti-inflammatory effect. Always tell your primary care doctor about any supplements you are taking. They may interact with other medications you take. Blepharitis is a chronic and incurable condition, but the symptoms can be controlled with the right treatment regimen.

If your blepharitis is severe, it may require a variety of different treatments or a more complex plan. Some people take a short course of topical antibiotics when blepharitis symptoms flare up (occasionally in conjunction with steroids, but only under a doctor’s supervision). Most patients are able to control their blepharitis symptoms, and the overall prognosis is good. Also keep in mind that if an underlying condition is the cause of your blepharitis, treating that condition is important to your treatment plan. Call your eye care provider for an appointment if symptoms worsen or do not improve after careful cleansing of the eyelids for several days. What’s the Prognosis for Blepharitis? In most cases, symptoms improve with treatment. For most people the condition is chronic, and symptoms come and go. Symptoms recur once treatment stops. Although symptoms have the potential to be severe, it’s rarely considered serious. In the Future, How Can I Prevent Blepharitis? It is extremely important that you see your eye doctor at least once a year.

Even if you do not have any symptoms, an eye exam is a great opportunity for you and your doctor to find out if anything is wrong, or if you have a condition such as blepharitis. Additional preventive measures you can take include: Keeping the area around your eyes clean with daily warm compresses and gentle lid hygiene Keeping your scalp clean and free of dandruff Treating skin disorders such as rosacea Avoiding dusty or smoky environments whenever possible Avoiding touching or rubbing your eyes, even after washing your hands Blepharitis Complications You Should Be Aware Of Never ignore symptoms of blepharitis. In severe cases, or when left untreated, blepharitis can cause complications such as:

Question: What specific part of the body is affected by blepharitis?
Answer: Eyelid